COMMUNITY HEALTH NURSING 2
LECTURE | WEEK 1
SIX GLOBAL HEALTH ISSUES
Pandemics
● Global disease outbreaks
● Example: Covid, influenza
Environmental factors
● Climate change is thought by many global health
experts to be the greatest threat to human health
● Climate change led to more extreme weather
● According to World Meteorological Organization (WMO)
- 11, 000 reported disasters (1970-2019)
- 2 million deaths, more than 91% of deaths occurred
in developing countries
- US$ 3.64 trillion
- Droughts, storms, floods, extreme temperature
● Storms, flooding, droughts, and air pollution make it
easier for diseases to spread across large groups of
people.
● Ex. Typhoon Odette (2021) – 6 regions affected
(Dinagat islands, Surigao del Norte, Bohol, Cebu,
Palawan), 9.9 million affected, 2.4 million were need of
assistance, 28 billion damage, 405 deaths, 66 missing
Economic Disparities and Access to Healthcare
● Communities across the world still lack access to basic
health education and health care
● Measured thru health Indicators
1. Data infrastructure
2. Process and outcome measures stratified by
subpopulations
3. Process and outcomes measures targeted at
specific subpopulations
4. Process and outcome measures targeted at
strategies intended to reduce inequities
Political factors
● Based on the leader, if the person with power cares
about health care, the leader will give importance to
health
Non-Communicable Diseases
● Hypertension, heart diseases, cancer, diabetes,
respiratory diseases
Animal Health, Food Sourcing and Supply
● Based on the leader, if the person with power cares
about health care, the leader will give importance to
health
Note: The ever-growing list of global health issues can be
overwhelming, but there are so many ways individuals
can make a positive impact
COMMUNITY HEALTH NURSING
Health
● Basic human right
● Continuum, goal of public health & community health
nursing
● WHO defines health as a “state of complete, mental,
and social well-being, not merely the absence of
disease or infirmity.”
Determinants of Health
Income and Higher income and social status is
social status linked to better health
Low levels of education are linked to
Education poor health, more stress and lower
self-confidence
Safe water, clean air, healthy
Physical
workplaces, safe houses, communities
environment
and roads all contribute to good health
Employment People in employment are healthier,
and working particularly those who have more
conditions control over their working conditions
Greater support from families, friends,
Social support
and communities is linked to better
networks
health
Culture Customs, belief, traditions affect health
Inheritance plays a part in determining
Genetics life span, healthiness and developing
certain illness
Personal Balanced eating, keeping active,
behavior and smoking, drinking and how we deal with
coping skills life’s stresses affect health
Health Access and use of services that prevent
Services and treat illness influence health
Men and women suffer from different
Gender
types of diseases at different ages
PUBLIC HEALTH NURSING AND COMMUNITY
HEALTH NURSING
Public Health
● Science and art of preventing diseases, prolonging
life, promoting health and efficiency through
organized community effort for the sanitation of
environment, control of communicable diseases, the
education of individuals in personal hygiene,
organization of medical and nursing services for early
diagnosis and preventing treatment of disease and the
development of social machinery to ensure everyone a
standard of living adequate for the maintenance of
health, so organizing these benefits as to enable every
citizen to realize his bright right of health and longevity
● Key phrase definition: "through organized community
effort"
● Connotes organized, legislated and tax-supported
efforts that serve all people through health departments
COMMUNITY HEALTH NURSING 2
LECTURE | WEEK 1

or related government agencies 3. Population group

4. Community
Public Health Nursing
● Special field of nursing that combines the skills of
Community Health
nursing, public health and some phases of social Public Health Nursing
Nursing
assistance and function as part of total public health
program for the promotion of health, the improvement of
the condition in social and physical environment, ● Whatever the local ● Has the same goals and
rehabilitation of illness and disability department of health employs the same
takes under its purview – strategies (health
Community infectious disease promotion, prevention
● Group of people who might have different prevention and etc), but is primarily
characteristics but share geographical location, setting eradication, organized around a
goals or social interests policymaking etc. geographic area.
● Characteristics of a Community ● Sets safety standards to ● Focuses more on
1. Determined by geographical boundaries protect workers and advocating for healthcare
2. Common values and interests develops school nutrition and medical services to
3. Its members know and interact with each other programs to ensure kids local communities but can
4. It functions within a particular social structures and have access to healthy be broader as it
exhibits and creates certain norms, values, and foods encompasses nursing
social institutions ● The practice of nursing practice in a variety of
in local or national health roles, which at times
Community Health departments (which include independent
● The health status of a defined group of people, or includes health centers nursing practice
community, and the actions and conditions that protect and rural health units
and improve the health of the community and public schools
Community Health Nursing ● Implementers of the
● The utilization of the nursing process in the different local government units’
levels of clientele-individuals, families, population mandate in promoting
groups and communities, concerned with the promotion and protecting the health
of health, prevention of disease and disability and of their constituents.
rehabilitation
● Global or umbrella term, broader and more general ROLES AND FUNCTIONS OF COMMUNITY/PUBLIC
speciality area that encompasses subspecialties that HEALTH NURSES
include public health nursing, school nursing,
occupational health nursing and other developing fields RA 9173: Nursing Law
of practice (home health, hospice care and independent Section 28 identifies the scope of nursing practice
nursing practice)
● Goal of professional practice is the promotion and Actual Duties and Responsibilities
preservation of the health populations
Public Health Nurses (PHNs)
● The nature of practice is comprehensive, general,
● The actual practice of community health nursing varies
continual and not episodic
from one community to another because the
● Knowledge base comes from nursing and public health
characteristics, needs and problems of clients differ
● The different levels of clientele - individual, families and
from each other
groups
● Municipalities and cities have different capabilities
● The practitioner's recognition of the primacy of the
● Various roles and functions of Public Health Nurses
population as a whole
- Management function
- Supervisory function
- Nursing care function
Concepts Applied from Public Health to Community
- Collaborating and coordinating function
Health Nursing - Health education and education function
● Emphasis on the "greatest good for the greatest - Training function
number" - Research function
● Assessing health needs, planning, implementing and Company Nurses / Occupational Health Nurses
evaluating the impact of health services on population (OHNs)
groups (ADPIE) ● Grouped into four headings by Occupational Health
● Priority of health-promotive and disease-preventive Nurses Association of the Philippines (OHNAP) -
strategies over curative interventions curative/palliative, preventive, educative and
● Tools for measuring and analyzing community health administrative functions
problems ● Major areas of concern: emergency and palliative care,
● Application of principles of management and family planning, counseling, immunization,
organization in the delivery of health services in the environmental sanitation, work safety, disaster
community prevention and control, orientation of new employees
Clients pf CHNs and health education.
1. Individual School Nurses (PHNs)
2. Family ● Most of the activities of school nurses are focused on
COMMUNITY HEALTH NURSING 2
LECTURE | WEEK 1
health promotion, disease prevention and early
detection of disease, emergency care and referral to
higher level health facilities.
● School nurses perform health assessment, screening,
and case-finding, health education and nursing
procedures
● Manage the school clinic (for in-house school nurses)
PRIMARY HEALTH CARE
● “The essential care made universally accessible to
individuals and families in the community through their
full preparation"
● LOI 949
- Legal basis of PHC in the PHL
- President Ferdinand Marcos Sr.
- "Health in the Hands of the People by 2020"
5 Key Elements
1. Reducing exclusion and social disparities in health
(universal coverage)
● Everyone has access to health regardless of their
status
2. Organizing health services around people’s needs and
expectations (health service reforms)
● All programs in public health are centered on the
needs of the community
3. Integrating health into all sectors (public policy reforms)
● Some programs that need higher levels of
intervention may need to be put into law (reducing
sugar in beverages or cessation of smoking)
4. Pursuing collaborative models of policy dialogue
(leadership reforms)
● Inclusive for all, leaders should be included
5. Increasing stakeholder participation
● Engagement of people
8 Essential Health Services (ELEMENTS)
E Education for health
L Locally endemic disease control
E Expanded program for immunization
Maternal and child health including responsible
M
parenthood
E Essential drugs
N Nutrition
Treatment for communicable and
T Jr.)
non-communicable diseases
S Safe water and sanitation
Extended Element In The 21st Century:
● Expended options of immunizations
● Reproductive health needs
● Provision of essential technologies for health
● Health promotion.
● Prevention and control of non-communicable diseases
● Food safety and the provision of selected food
supplements
4 Principles of PHC
1. Equity/ Equitable Distribution
● Mabibigyan lahat pero hindi pantay-pantay yung
ibibigay pero depende sa pangangailangan ng tao
2. Community Participation
● Kailangan involve yung community
3. Intersectoral Coordination
● Coordination of all sectors para maging successful
yung health services or health programs
4. Appropriate Technology
● Using of available technologies para mabigay yung
health needs
4 A’s in PHC
Accessibility
● Distance/travel time required to get to a healthcare
facility or services (the home must be within 30 minutes
from the Brgy. health stations)
Affordability
● Consideration of the individual, family, community and
government can afford the services
Acceptability
● Health care services are compatible with the culture
and traditions of the population
Availability
● A question whether the health service are offered in
health care facilities or is provided on a regular and
organized manner
UNIVERSAL HEALTH CARE LAW
RA 11223: The Universal Health Care Law
● Signed by Rodrigo Duterte
● Expansion of population, service, and financial
coverage
● Shift to primary care
● All Filipinos guaranteed “equitable access to quality and
affordable health care goods and services and
protected against financial risk
● Ensure every Filipino is healthy, protected from health
hazards and risks, and has access to affordable, quality
and readily available health service that is suitable to
their need
● DOH is the Lead Agency
● New DOH Chief Health Secretary 2023: Teodoro
Herbosa (Appointed by President Ferdinand R. Marcos
General Objectives
● To progressively realize universal health care through
systemic approach and clear role delineation of
stakeholders
● To ensure equitable access to quality and affordable
health care and protection against financial risk
Declaration of Principles
● Integrated and comprehensive approach
● Whole of system, whole of government, whole of
society approach
● Comprehensive health services without causing
financial hardship
● People oriented approach
COMMUNITY HEALTH NURSING 2
LECTURE | WEEK 1

Universal Health Care improvement of the health of its citizens and

● Healthy living, schooling and working environments communities
● Primary care provider team for every family ● Comprises all organizations, institutions and resources
● Healthy spending is predictable not “lahat libre” devoted to producing actions whose primary intent is to
improve health
Salient Features of UHC Law
Healthcare System Organized plan of health service
Financing
● All Filipinos automatically be member of Philhealth
Rendering health services to
● Families not registered – assisted by their healthcare Healthcare Delivery
people
provider
● Philhealth ID will not require availing services
network of health facilities and
● Direct and Indirect Contributors
Healthcare Delivery personnel which carries out the
● Private Sector Financing Agents – offer complementary
System task of rendering health care to
or supplementary benefit packages
the people
● Service Coverage - “Preventive, promotive, curative,
rehabilitative and palliative care for medical, dental
mental and emergency health services delivered either Levels of Healthcare and Referral System
as population-based or individual-based health
Primary Level Care
services.
● Barangay Health Stations
Service Delivery ● Private Practitioners Clinic
● Health care provider network (HCPN) - group of primary ● Community Hospitals and Health Centers
to tertiary care providers (public or private), offering ● Rural Health Unit
people-centered and comprehensive care in an Secondary Level Care
integrated manner with the primary care provider acting ● Emergency District Hospitals
as the navigator and coordinator. ● Provincial/City Hospitals
● Primary Care Provider Network refers to a group of ● Provincial/City Health Services
public, private or mixed primary care providers as the Tertiary Level Care (Regional)
foundation of HCPN. ● Regional Health Services
● Organization of Local Health Systems: ● Regional Medical Centers and Training Hospitals
- Province-wide and City-wide Health systems Tertiary Level Care (National)
- Provincial/ City Health Board ● National Health Services
- Provincial/ City health office ● Medical Centers
- Incentives for improving competitiveness ● Teaching and Training Hospitals
Human Resources for Health
● National Health Human Resource Master Plan
● National Health Workforce support system
Regulation
● Safety and quality
● Affordability
● Equity
Governance and Accountability
● Health Promotion
● Evidence-Informed sectoral; policy and planning for
UHC
● Monitoring and Evaluation
● Health Impact Assessment
● Health Technology Assessment
● Ethics in public health policy and practice
● Health information system
● Appropriation

PHILIPPINE HEALTHCARE DELIVERY SYSTEM

Health System
● Interrelated system in which a country organizes
available resources for the maintenance an